fellowship application

The VACEP Leadership & Advocacy Fellowship is designed to develop future emergency medicine leaders. The fellowship combines elements of mentoring, with skills in organization, education, advocacy, and involvement. Applications open on March 31, 2023 and the deadline to submit is May 31, 2023.

MORE INFORMATION ON the fellowship

Note: The last few questions below require a little writing on your part. We suggest reviewing those questions, writing the responses separately, then pasting into the form.

Name of applicant/nominee:

First Name

Last Name

Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email:

Phone number:

Hospital/Physician Group Affiliation

Number of years as ACEP/EMRA member:

State or national activities related to organized medicine

Please list any activities in which you have participated, including leadership positions, committee or task force involvement, etc., which are not included in your CV.

List your membership in other medical associations

In 500 words or less, discuss any or all of the following:

o Your reasons for interest in the Leadership & Advocacy Fellowship. o Why you should be selected for this Fellowship. o How your participation in the Fellowship will benefit your state, physician group, hospital and/or patients.

What is the biggest challenge in your day-to-day clinical practice?

If you could wave a magic wand and change one thing about emergency medicine, what would it be?